arXiv subjects

Linda Z. Sun

Publications and source records attributed to Linda Z. Sun.

4 recordsLinked to original sources

arXiv2025

Advancing Waterfall Plots for Cancer Treatment Response Assessment through Adjustment of Incomplete Follow-Up Time

Waterfall plots are a key tool in early phase oncology clinical studies for visualizing individual patients' tumor size changes and provide efficacy assessment. However, comparing waterfall plots from ongoing studies with limited follow-up to those from completed studies with long follow-up is challenging due to underestimation of tumor response in ongoing patients. To address this, we propose a novel adjustment method that projects the waterfall plot of an ongoing study to approximate its appearance with sufficient follow-up. Recognizing that waterfall plots are simply rotated survival functions of best tumor size reduction from the baseline (in percentage), we frame the problem in a survival analysis context and adjust weight of each ongoing patients in an interim look Kaplan-Meier curve by leveraging the probability of potential tumor response improvement (i.e., "censoring"). The probability of improvement is quantified through an incomplete multinomial model to estimate the best tumor size change occurrence at each scan time. The adjusted waterfall plots of experimental treatments from ongoing studies are suitable for comparison with historical controls from completed studies, without requiring individual-level data of those controls. A real-data example demonstrates the utility of this method for robust efficacy evaluations.

stat.AP↗

arXiv2023

Adjusted inference for multiple testing procedure in group sequential designs

Adjustment of statistical significance levels for repeated analysis in group sequential trials has been understood for some time. Similarly, methods for adjustment accounting for testing multiple hypotheses are common. There is limited research on simultaneously adjusting for both multiple hypothesis testing and multiple analyses of one or more hypotheses. We address this gap by proposing adjusted-sequential p-values that reject an elementary hypothesis when its adjusted-sequential p-values are less than or equal to the family-wise Type I error rate (FWER) in a group sequential design. We also propose sequential p-values for intersection hypotheses as a tool to compute adjusted sequential p-values for elementary hypotheses. We demonstrate the application using weighted Bonferroni tests and weighted parametric tests, comparing adjusted sequential p-values to a desired FWER for inference on each elementary hypothesis tested.

stat.ME↗

arXiv2021

A unified framework for weighted parametric group sequential design (WPGSD)

Group sequential design (GSD) is widely used in clinical trials in which correlated tests of multiple hypotheses are used. Multiple primary objectives resulting in tests with known correlations include evaluating 1) multiple experimental treatment arms, 2) multiple populations, 3) the combination of multiple arms and multiple populations, or 4) any asymptotically multivariate normal tests. In this paper, we focus on the first 3 of these and extend the framework of the weighted parametric multiple test procedure from fixed designs with a single analysis per objective to a GSD setting where different objectives may be assessed at the same or different times, each in a group sequential fashion. Pragmatic methods for design and analysis of weighted parametric group sequential design(WPGSD) under closed testing procedures are proposed to maintain the strong control of familywise Type I error rate (FWER) when correlations between tests are incorporated. This results in the ability to relax testing bounds compared to designs not fully adjusting for known correlations, increasing power or allowing decreased sample size. We illustrate the proposed methods using clinical trial examples and conduct a simulation study to evaluate the operating characteristics.

stat.ME↗

arXiv2021

Independent Action Models and Prediction of Combination Treatment Effects for Response Rate, Duration of Response and Tumor Size Change in Oncology Drug Development

An unprecedented number of new cancer targets are in development, and most are being developed in combination therapies. Early oncology development is strategically challenged in choosing the best combinations to move forward to late stage development. The most common early endpoints to be assessed in such decision-making include objective response rate, duration of response and tumor size change. In this paper, using independent-drug-action and Bliss-drug-independence concepts as a foundation, we introduce simple models to predict combination therapy efficacy for duration of response and tumor size change. These models complement previous publications using the independent action models (Palmer 2017, Schmidt 2020) to predict progression-free survival and objective response rate and serve as new predictive models to understand drug combinations for early endpoints. The models can be applied to predict the combination treatment effect for early endpoints given monotherapy data, or to estimate the possible effect of one monotherapy in the combination if data are available from the combination therapy and the other monotherapy. Such quantitative work facilitates efficient oncology drug development.

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